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Biomedical subjects

L Napolitano

Publications and source records attributed to L Napolitano.

At least 19 recordsLinked to original sources

[Clinical study of metastasis of thyroid differentiated carcinoma].

The Authors report 5 cases of distant metastases of well-differentiated thyroid carcinoma over a number of 114 patients operated for thyroid neoplasm (4.3%). In 101 pts was total thyrodectomy performed, in 13 pts underwent istmo lobectomy. Distant metastases were verified in 3 patients with follicular and in 2 patients with papillary carcinoma. In 2 cases the metastases were in lungs, in 2 cases are the bone, and in one patient in lungs and bones. In 3 patients istmolobectomy had been performed at first operation. All the patients were treated with radioiodine. Three patients were alive after 3, 5 e 10 years from the diagnosis of metastases, 2 of them are presently disease free.

Carcinoma↗

[Reoperations in thyroid surgery].

The Authors examine etiology, incidence and hazards related to reoperation in thyroid surgery either for benign either for malignant pathology. The Authors present, then, 26 secondary operations performed in the Unit of Surgical Pathology of the Department of Surgical Sciences Chieti University: 15 for benign, 11 for malignant pathology. In the cases of thyroid malignant pathology, in 2 patients (operated in different hospitals) there was a parenchimatous recurrence, in 2 patients a lymphnodal recurrence. In all the patients a total thyroidectomy was performed, in one patient associated with lymphadenectomy. In the patients with lymphadenomatous recurrence a functional laterocervical lymphadenectomy was performed.

Follow-Up Studies↗

Determination of the primary structure of two lipid transfer proteins from apricot (Prunus armeniaca).

It has been recently demonstrated that the major allergen of apricot is a protein of molecular mass (Mr) 9000 belonging to the family of Lipid Transfer Protein. The aim of this study was the determination of the primary structure of apricot LTP by micro-sequencing and mass spectrometric analyses. Apricot LTP is a 91 amino acids protein like peach and almond LTPs with a sequence identity of 91% and 94%, respectively. Like for the peach LTP, out of the 25 amino acids forming the inner surface of the tunnel-like hydrophobic cavity in maize ns-LTP, 16 are identical and 7 similar in the apricot LTP, supporting the hypothesis of a similar function.

Amino Acid Sequence↗

[Duodenal obstruction: unusual complication of acute pancreatitis].

The authors notice that, though the duodenal involvement in patients with acute pancreatitis is very common, the duodenal obstruction is quite exceptional and the reported cases are very few. The Authors describe; then, the case of a patient with duodenal obstruction caused by a peri-duodenal phlegmon due to an acute pancreatitis treated with a gastro-jejunostomy and a drainage of the abscess.

Acute Disease↗

Treatment of the contralateral negative neck in supraglottic cancer patients with unilateral node metastases (N1-3).

BACKGROUND: Elective treatment of the contralateral N0 neck in supraglottic cancer patients with unilateral metastases is controversial. METHODS: We reviewed 127 N1-3 cases with contralateral negative necks to compare elective contralateral dissection (ED: 24 cases) with a contralateral wait-and-see policy (WS: 103 cases) and subsequent delayed therapy (SDT: 40 cases) when contralateral disease became evident. Prognostic factors were studied to identify the risk of contralateral disease. RESULTS: Nine of 24 (37.5%) ED patients had occult contralateral metastases, and 40 of 103 (38.8%) WS patients had a delayed contralateral failure. Supraglottic cancers involving or extending up to the midline had a higher risk of contralateral metastases compared with well-lateralized tumors (p =.049). The risk of contralateral neck disease was more influenced by tumor site and stage than by histopathologic characteristics of ipsilateral metastases. WS patients with contralateral neck relapse showed a higher risk of distant metastases and of level I and V neck involvement than ED cases with no difference in terms of survival. CONCLUSIONS: The risk of contralateral occult neck involvement in supraglottic laryngeal cancers with unilateral metastases is high (about 40%), particularly for more advanced lesions extending to or involving the midline larynx; thus, a bilateral neck treatment in such cases is recommended.

Adult↗

Identification of the human beta-casein C-terminal fragments that specifically bind to purified antibodies to bovine beta-lactoglobulin.

The presence of foreign proteins in human milk after the ingestion of bovine dairy products is thought to be one of the possible causes of allergic sensitization in exclusively breast-fed predisposed infants. The immunologic determination of bovine beta-lactoglobulin (LG) concentration in human milk has been reported by several researchers, but the results are conflicting. Moreover, a strong cross-reactivity between antibodies to bovine beta-LG and human milk proteins and peptides was reported, throwing doubt on the reliability of radioimmunoassay and enzyme-linked immunosorbent assay detection and quantification assays for bovine beta-LG in human milk. Thus, the goal of this study was to isolate human milk peptides with a molecular mass >or= 1,000 Da cross-reactive with antibodies to bovine beta-LG in order to identify possible common epitopes between human and bovine milk proteins. The proteins were first isolated by affinity chromatography with purified polyclonal antibodies to bovine beta-LG, followed by gel filtration fast phase liquid chromatography and reverse phase-high performance liquid chromatography purification of the components specifically bound in the affinity separation step. Affinity-bound peptides were identified by determining their amino acid sequence. All the sequenced peptides belonged to the C-terminal part of human beta-casein, which confirms the cross-reactivity of human milk proteins and peptides with antibodies to bovine beta-LG and allows the identification of possible common epitopes between the two proteins. No bovine beta-LG peptides with a molecular mass >or= 1,000 Da were found in our milk samples from healthy mothers on a diet rich in bovine milk and dairy products.

Journal Article↗

Complete amino acid sequence determination of the major allergen of peach (Prunus persica) Pru p 1.

The major protein allergen of peach (Prunus persica), Pru p 1, has recently been identified as a lipid transfer protein (LTP). The complete primary structure of Pru p 1, obtained by direct amino acid sequence and liquid chromatography-mass spectrometry (LC-MS) analyses with the purified protein, is described here. The protein consists of 91 amino acids with a calculated molecular mass of 9178 Da. The amino acid sequence contains eight strictly conserved cysteines, as do all known LTPs, but secondary structure predictions failed to classify the peach 9 kDa protein as an 'all-alpha type', due to the high frequency of amino acids (nine prolines) disrupting alpha helices. Although the sequence similarity with maize LTP is only 63%, out of the 25 amino acids forming the inner surface of the tunnel-like hydrophobic cavity in maize ns-LTP 16 are identical and 7 similar in the peach homolog, supporting the hypothesis of a similar function.

Allergens↗

[Acute thrombosis of the infrarenal aorta].

The Authors report three cases of patients operated for acute thrombotic aortic occlusion. All the three patients were treated with an aortic transabdominal approach, thromboendarteriectomy and aorto-femoral by-pass. In two patients the result was satisfying, one with a late and partial recovery of the motility of the inferior limbs. One patient died for heart failure in eighth postoperative day. The Authors believe that this unsatisfying result was caused by delay in the surgical treatment (almost 30 hours).

Acute Disease↗

Evidence for a common epitope between bovine alpha-lactalbumin and beta-lactoglobulin.

The aim of this work was to check and quantify any cross-reactivities among the main bovine whey proteins, utilizing purified polyclonal antibodies against bovine beta-lactoglobulin, alpha-lactalbumin and serum albumin, and to identify possible common epitope(s). Purified polyclonal anti-bovine beta-lactoglobulin antibodies show 10% cross-reactivity with bovine alpha-lactalbumin, both in its native and its denatured form. A continuous stretch of four amino acids common to alpha-lactalbumin and beta-lactoglobulin that might be responsible for this cross-reactivity has been identified. Cross-reactivity between this antibody and bovine serum albumin is, on the contrary, negligible. Purified polyclonal anti-bovine alpha-lactalbumin and anti-serum albumin antibodies do not cross-react.

Amino Acid Sequence↗

The unusual amino acid triplet Asn-Ile-Cys is a glycosylation consensus site in human alpha-lactalbumin.

Human alpha-lactalbumin has not been described as a glycoprotein, despite the fact that several alpha-lactalbumins of both ruminant and nonruminant species are known to be glycosylated. In all these species the glycosylation site is the 45Asn in the usual triplet 45Asn-Gly/Gln-47Ser. We have found that human alpha-lactalbumin is glycosylated and the glycosylation site has been determined by protein sequencing and mass spectrometry. We report an unusual glycosylation site at 71Asn in the triplet 71Asn-Ile-73Cys, which is conserved in all known alpha-lactalbumins except red-necked wallaby. That a relatively small proportion of the protein is glycosylated (about 1%) may reflect the importance of this region of the protein sequence to the molten globule state of alpha-lactalbumin.

Amino Acid Sequence↗

[Unusual pathology of the spleen].

The Authors report 7 cases of unusual spleen pathology represented by 2 real cysts, 1 pseudocyst, 1 hydatid cyst, 2 abscesses, 1 splenic artery aneurysm. Pathophysiological hypotheses are examined, and clinical and diagnostic considerations are stressed, evaluating particularly anatomo-histologic characteristics and the differential diagnosis through non invasive imaging techniques. All patients were subjected to splenectomy via laparotomy, except for the case of real cyst where an inferior hemisplenectomy was performed. In the case of splenic artery aneurysm, an urgent aneurysmectomy was required together with splenectomy, considering the young age of the patient (29 years old), and the type of aneurysm presenting in a double rupture phase. Reoperation was necessary in only one patient to drain an hematic abscess. After a 9 year follow up all the patients are well.

Abscess↗

[Personal experience in the treatment of carcinoma of the head of the pancreas].

The Authors report 195 cases of carcinoma of the head of the pancreas observed in the period 1983-1995. Only 94 (48%) of these patients were operated: in 32 cases an exploratory laparotomy was performed, while in 36 a bilio-digestive bypass, associated in 2 patients with a gastro-jejunal bypass was assured. In 26 patients a resection was performed: in 12 a Whipple procedure, in 6 a total duodenopancreatectomy, in 8 a pylorus preserving procedure (Traverso-Longmire). The mean survival was 2 months after laparotomy, 6 months after bilio-digestive bypass, 20 months after Whipple procedure, 20 months after total duodenopancreatectomy, 23 months after a pylorus preserving procedure (Traverso-Longmire). The Authors believe that the Whipple procedure is the treatment of choice for the carcinoma of the head of the pancreas. Only in cases of suspected multifocality or when there is a severe nodal involvement it is advisable to perform a total duodenopancreatectomy.

Biliopancreatic Diversion↗

Amino acid sequence and crystal structure of buffalo alpha-lactalbumin.

Isolation, purification, amino acid sequence determination and X-ray crystal structure of buffalo alpha-lactalbumin were performed in order to gain further knowledge of the molecular basis of alpha-lactalbumin in the lactose synthase complex. The deduced amino acid sequence differs at one position from the bovine alpha-lactalbumin sequence (at position 17). The refined crystal structure at 2.3 A is very similar to those previously reported for human and baboon alpha-lactalbumins. However, a portion of the molecule (residues 105-109) exhibits different conformation. It forms a 'flexible loop', and appears to be a functionally important region in forming the lactose synthase complex.

Amino Acid Sequence↗

[Skeletization of the inferior mesenteric artery in colorectal surgery. Current considerations].

Anastomotic dehiscence after colon resection is the most frequent complication in colon surgery and the main cause of post-operative death. In the light of anatomical peculiarities of the blood supply to the rectum, it would appear that in atherosclerotic patients with impairment of hypogastric arteries (80% in authors' series out of 200 atherosclerotic subjects) inferior mesenteric artery ligature, determining vascularization of the rectal ampulla by the distal vessels alone, results in an insufficient supply in case of colo-rectal anastomosis. A series of 15 cases of cancer of the left and sigmoid colon, treated with left hemicolectomy, preservation and peeling of the inferior mesenteric artery, is reported. In the follow-up ranging from 6 months to 5 years, no anastomotic dehiscence was observed and only one case (7.5%) presented hepatic recurrence after two years. The other patients are all alive and disease free.

Aged↗

[Medullary carcinoma of the thyroid].

Medullary thyroid carcinoma represents 4-8% of thyroid malignancies; regional nodal involvement is commonly found, even at the time of first surgical approach. In these patients after surgical resection, other therapeutic choices are really limited. The Authors evaluated their experience in the period 1981-1994, concerning 14 patients, 9 females and 5 males, all affected with sporadic MTC. Diagnosis was preoperative in 10 patients and intraoperative in 4; as for the staging: in 8 patients the tumor resulted confined to the thyroid, while in the remaining 6 patients it was extra-thyroidal. In 5 patients a total thyroidectomy with regional lymphadenectomy was performed, with in 6 patients a total thyroidectomy with cervico-mediastinic total lymphadenectomy was achieved. Survival was evaluated with a short, follow-up (3 months) and calculated using the K-Mayer method. Average survival was: 5 years in patients undergoing only total thyroidectomy; 3 years and 1 month in patients undergoing total thyroidectomy and lymphadenectomy; 6 months in patients undergoing no treatment at all. Among the factors negatively affecting patients survival, the Authors pointed out: metastasis occurrence; incomplete resection and mediastinal metastasis. In conclusion surgical resection (total thyroidectomy) associated with radical lymphadenectomy resulted to be a good approach. However, prognostic factors require further investigation.

Adult↗

Human alpha S1-casein like protein: purification and N-terminal sequence determination.

Casein components of human milk are generally reported to belong to the beta- and kappa-groups. In this research human casein fraction was obtained from pooled mature milk, either by ultracentrifugation or by acid precipitation. In both cases a minor component with a slightly higher mobility in SDS-PAGE than beta-casein was identified. The protein was purified to homogeneity, the N-terminal sequence of the first 14 amino acid residues of this new human casein subunit shows a high degree of homology with the alpha s1-casein sequences from other species.

Amino Acid Sequence↗

The amino-acid sequence of two isoforms of alpha-lactalbumin from donkey (Equus asinus) milk is identical.

The complete primary structure of donkey alpha-lactalbumin A and B has been determined by sequencing of the peptides obtained after tryptic, Glu-C proteinase or cyanogen bromide cleavage. Although preparative purification of alpha-lactalbumin by flat-bed isoelectric focusing gave two protein fractions A and B, their amino-acid sequence revealed no differences. Donkey alpha-lactalbumin shows two, four and five differences in comparison to the horse alpha-lactalbumin A, B and C. Thus donkey alpha-lactalbumin is homogeneous and belongs to the horse A-type variant.

Amino Acid Sequence↗